Provider Demographics
NPI:1881696508
Name:BAKER, MICHAEL NOBLES (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:NOBLES
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1457 BAILEY ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5943
Mailing Address - Country:US
Mailing Address - Phone:559-583-0118
Mailing Address - Fax:559-583-0567
Practice Address - Street 1:1457 BAILEY ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5943
Practice Address - Country:US
Practice Address - Phone:559-583-0118
Practice Address - Fax:559-583-0567
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40848204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A408480Medicaid
CA00A408480Medicare ID - Type UnspecifiedPROVIDER NUMBER
CA00A408480Medicaid